Gillings School of Public Health hosts seminar on striving for equity in health care

The Gillings School of Global Public Health hosted “Truth to Power: Building Solidarity for Health and Democracy" on Sept. 16, a webinar with Amanda Maria Navarro, chief impact officer for PolicyLink.  

Navarro spoke on reforming the definition of inclusion, inherent racial bias finding its way into policy and racism as an issue of public health.

Defining inclusion

Derrick Matthews, an assistant professor in the school, asked Navarro to share the “good, bad and ugly” of being a public health professional promoting social justice. 

Navarro shared her experience working with Latinx women on a 12-week HIV prevention program. During the program, a survey was handed out asking the women about their level of trust in their partners, Navarro said. 

"At the beginning of the baseline of the survey that we did with the cohort of women, they said that they had a high level of trust in their partners, and at the end, their trust went down," Navarro said. 

Navarro said these results raised question due to the ultimate outcome of less trust. 

"Several things in hindsight made me wonder, 'Wow, if our ultimate goal is to make sure that Latinx women were better supported and provided the services they needed to prevent HIV transmission, then they should be part of the process, and being part of co-designing the curriculum, or co-designing the research and evaluation,'" Navarro said. 

Inherent racial bias in policy

Brooke Staley, a doctoral student at UNC, asked Navarro about what it takes to make a change in policy. 

Navarro said that while working at the Centers for Disease Control and Prevention, specifically at the Racial and Ethnic Approaches to Community Health program, she learned about how the government works and how bureaucracy is set up to be incremental.

“All of this was extremely helpful for me to understand the rules of the game," Navarro said. "I was trying to push for participatory research, having community members own and aid the research evaluation process and co-design that with me."

Navarro said it is important to have data in the hands of the community for them to determine what actions that need to be taken.

“There is a need for public health students in the field to begin to see themselves as advocates and activists," Navarro said.

Racism and public health 

Chris Tilden, a former colleague and public health official in Kansas, asked Navarro about a new community plan that would focus on equity. 

Navarro said it is important to have a working group or lead digging into how to start operationalizing equity. Navarro said PolicyLink is leading a team of chief equity officers across 10 cities to work with local leaders to issue declarations of racism as a public health issue.  

But often in these roles, there is not real support from leadership, in addition to not having any funding or staff for their work, Navarro said.

"So it ends up being superficial in that you have someone in a position that they actually cannot do their job," Navarro said.

Navarro said overall, her goal is to ensure that policy starts with people. 

“It’s important to ask different types of questions and make sure, in those questions, we really understand who’s benefitting from the particular policy or practice change that we’re making," Navarro said. "Who’s deciding? Who’s owning? Who will pay or be harmed? Who is leading and who is missing?"

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